Exercise capacity, quality of life, and daily activity in the long-term follow-up of patients with univentricular heart and total cavopulmonary connection

Abstract

Despite their diminished exercise capacity, patients after TCPC show a fairly normal activity pattern. However, their activity depends not only on age, but also on exercise capacity, which, in contrast to healthy people, decreases already from early adolescence on.

Congenital Heart Disease in the Older Adult

“…Exercise intolerance has been documented in all ages of CHD [165][166][167][168][169]335 and is associated with an increased risk for hospitalization and death. 168,176 Early data suggest that cardiopulmonary exercise testing, especially peak oxygen consumption (peak Vȯ 2 ) and heart rate reserve, may provide prognostic information in ACHD.…”

Reference values for cardiopulmonary exercise testing in children and adolescents in northwest Croatia

“…The fourth indication is to assess the risk of future disease complications, for instance, complex premature ventricular contractions (PVCs) during exercise in hypertrophic cardiomyopathy, arrhythmias and risk of sudden death late after tetralogy of Fallot repair (12), to assess ability to increase oxygen delivery and CO2 elimination in patients with half of the heart, where there is no ventricle that is pumping blood in the lung and all pulmonary infl ow depends on total cavopulmonary connection and pulmonary resistance (13). An additional indication for CPET is to inspire confi dence in children and parents, to teach children and parents about preventive eff ects of sports in life in healthy children or in a population of children with CHD, where parents are often overprotecting their children, even though the underlying disorder is only mild and might not be restrictive for performing physical activities including competitive sports (9,(13)(14)(15)(16)(17) The parameters that are measured during CPET include simple measures such as peak work rate (WRpeak) and heart rate (HR) response to exercise, peak oxygen uptake (VO2peak), and more recently proposed measures as the ventilation to carbon dioxide exhalation (VE/VCO2) slope. Additional ventilatory control parameters during exercise in children are minute ventilation (VE), assessment of anaerobic threshold (AT), respiratory compensation point (RCP), oxygen uptake (VO2), carbon dioxide output (VCO2), ventilatory equivalents for carbon dioxide and oxygen (VE/VCO2, VE/VCO2), oxygen pulse (VO2/HR), physiological dead space-tidal volume ratio (VD/VT), end-tidal pCO2 (PETCO2), end-tidal pO2 (PETO2), gas exchange ratio (R), the increase in oxygen uptake in response to a simultaneous increase in work rate (ΔVO2/ΔWR), breathing reserve (BR), and heart rate reserve (HRR) (1).…”

Increase in N-Terminus-Pro-B-Type Natriuretic Peptide During Exercise of Patients With Univentricular Heart After a Total Cavopulmonary Connection

“…Data concerning exercise capacity, quality of life, and daily activity were published recently [31]. We report on the NT-proBNP levels of patients at rest and after a symptom-limited cardiopulmonary exercise test (CPET).…”

“…All the patients performed a symptom-limited CPET on an upright cycle ergometer as previously described [31]. Venous blood samples were drawn before the exercise test and then 2-3 min after peak exercise.…”